Nimesles: instructions for use,contraindications, side effects, analogues

Update: October 2018

Nimesil is an analgesic and antipyretic drug with
pronounced anti-inflammatory effect. Refers to the group
non-hormonal anti-inflammatory drugs from the class
sulfonamides.

The active ingredient of Nimesil is nimesulide, which provides
powerful system action. Effective in the treatment of inflammatory
feverish conditions, infectious and rheumatic processes,
pronounced pain syndrome of various etiologies.

Exceeds in action popular drugs from the group of NSAIDs
(ibuprofen, diclofenac), working directly in the outbreak
inflammation, but it has a wide range of contraindications and
side effects.

It should be understood that with all its high efficiency
Nimesil is intended for symptomatic therapy, acting on
moment of use and without affecting the etiological cause
diseases.

Farmgroup: NPVS – Non-steroidal anti-inflammatory
drugs.

The composition of the drug

  • Active ingredient: Nimesulide 100 mg;
  • Excipients: sucrose, ketomacrogol 1000,
    maltodextrin, anhydrous citric acid, orange
    flavoring.

Release form

Nimesil is produced in the form of granular granules for preparation
oral suspensions having a light yellow color and
orange smell. In one paper laminated bag – 2
gram of powder. Cardboard packs on 9, 15, 30 bags.

Price:

  • 1 bag of 22-40 rubles,
  • 30 bags 611-890 rub.

pharmachologic effect

Nimesulide has a pronounced effect on metabolism.
arachidonic acid, inhibiting mainly cyclooxygenase-2.
Owing to these processes, the biosynthesis of prostaglandins decreases,
mediators of inflammatory and allergic reactions, and
smooth muscle organs.

The drug quickly blocks the release of histamine from mast cells,
slows down the synthesis of metalloprotease, elastase and collagenase,
thus protecting the cartilage from destruction. Suppresses
release of tumor necrosis factor alpha, reducing the effect
kinin, causing expansion of the vascular wall. Reduces production
neutrophils of superoxide anions and the formation of free
radicals playing an important role in the development of inflammatory
reaction.

Due to the nature of this dosage form of nimesulide
Nimesil’s effectiveness develops rapidly and continues throughout
6 o’clock.

Pharmacokinetics

According to the instructions for use Nimesila after taking
suspension the drug is rapidly absorbed through the digestive tract, reaching
maximum therapeutic concentration after 2-3 hours.
It is characterized by a high bond with blood proteins, up to 97.5%, easy
passes through histohematogenous barriers.

Metabolism of the drug occurs in the liver using P450 (CYP)
2C9: cytochrome isoenzyme. The main metabolite is hydroxynimesulide,
pharmacologically active nimesulide derivative. Displayed through
bile metabolized.

About 50% of the accepted amount of Nimesila is displayed
by the kidneys.

Indications for use

  • Treatment of osteochondrosis, rheumatoid arthritis as
    symptomatic therapy.

    • headache;
    • back pain, back pain;
    • myalgia;
    • pain accompanying injuries, sprains, inflammation and
      dislocation of the joints;
    • toothache;
    • postoperative period.
  • Treatment of acute pain symptom
  • Algomenorrhea.
  • Symptomatic treatment of gynecological, vascular and
    otorhinolaryngological diseases.
  • Inflammatory diseases with fever (except
    SARS and colds).

Contraindications

Contraindications: It is prescribed with caution in the following pathologies and
factors:
  • Hypersensitivity to active substance (nimesulide)
    or an auxiliary component of the drug.
  • Hyperargic reactions of the body in history: rhinitis,
    urticaria, bronchospasm, laryngospasm associated with taking any
    drug from the group of NSAIDs, including nimesulide.
  • Hepatotoxic reactions of the body to nimesulide in
    anamnesis
  • Simultaneous treatment with other drugs that have
    hepatotoxic action (especially from the group of spits).
  • Inflammatory processes in the intestine in the acute phase (b-nh
    Crohn, ulcerative colitis).
  • Recovery period after coronary artery
    shunting
  • Fever accompanying colds and ARVI.
  • A combination of bronchial asthma, polyposis of the paranasal sinuses or
    nasal nose with recurrent course and intolerance to NSAIDs in
    anamnesis;
  • Aggravation of gastric or duodenal ulcers;
  • Язва с кровотечением или перфорацией в anamnesis;
  • Цереброваскулярные и иные кровотечения в anamnesis;
  • Bleeding disorders;
  • Violation of blood clotting of a severe nature;
  • Severe heart failure;
  • Renal failure in severe;
  • Confirmed hyperkalemia;
  • Liver disease in the acute phase;
  • Liver failure;
  • Children under 12;
  • Pregnancy, lactation;
  • Drug addiction, alcoholism.
  • heart failure of any degree;
  • severe hypertension;
  • type 2 diabetes;
  • CHD;
  • hereditary fructose intolerance;
  • glucose-galactose malabsorption;
  • sucrose-isomaltose deficiency;
  • dis- or hyperlipidemia;
  • cerebrovascular pathology;
  • severe somatic diseases;
  • arterial disease (peripheral);
  • Helicobacter pylori infection;
  • creatinine clearance less than 60 ml / min;
  • long-term treatment of NSAIDs;
  • elderly age;
  • smoking.

Dosage

Before using the contents of the bag (granules) pour in
glass and add about 100 ml of water, mix to obtain
homogeneous suspension. It’s impossible to store the prepared solution, therefore
Prepare immediately before use.

  • Accepted after a meal, 1 sachet (pre-dissolved) 2
    times a day.
  • The maximum duration of receiving Nimesil is 15 days,
    however, in order to eliminate the risk of adverse reactions optimal
    is the appointment of the drug short course (5-7 days).
  • Teenagers from 12 to 18 years old take Nimesil in the recommended above.
    dose.
  • The decision on dose adjustment for elderly patients is made.
    individually.

Patients with renal insufficiency (mild and moderate
degree) does not require correction of the dose and intervals of administration. During
clinical trials in these patients there are elongated in
twice the time interval to reach maximum concentration
blood nimesulide and the half-life of active metabolites
substances that fall within the pharmacokinetic limits
values.

Side effect

  • Hematopoietic system: anemia and eosinophilia may develop,
    hemorrhagic syndrome; very rarely – patient,
    thrombocytopenia and thrombocytopenic purpura.
  • Allergic reactions: itching, skin rash,
    excessive sweating; less likely to develop stronger reactions
    hypersensitivity – dermatitis, erythema, urticaria,
    angioedema, anaphylactoid reactions, syndrome
    Stevens Johnson and Lyell.
  • CNS: dizziness; less likely to develop – a feeling of fear, night
    nightmares, nervousness, drowsiness, headache,
    encephalopathy.
  • Bodies of vision: blurred vision is rarely observed.
  • CCC: tachycardia, arterial hypertension, lability are likely
    blood pressure, tidal sensation.
  • Respiratory: sometimes shortness of breath; less often – bronchospasm,
    exacerbation of bronchial asthma.
  • Digestive organs: often develop vomiting and nausea, as well as
    diarrhea, constipation and flatulence, gastropathy, dyspepsia,
    abdominal pain, tarry stools, stomatitis. Very rarely
    gastrointestinal bleeding occurs, ulcerative
    damage to the gastrointestinal tract, hepatitis, cholestasis, jaundice, an increase
    liver enzymes.
  • Urinary system: rarely hematuria, dysuria,
    urinary retention; extremely rarely renal formation
    deficiency, interstitial nephritis, oliguria.
  • General disorders: malaise, asthenic condition, less often –
    hypothermia.
  • Blood change: hyperkalemia is very rare.

Overdose

Symptoms of an overdose are: drowsiness, apathy, nausea and
vomiting, pain in the epigastric region, may develop
gastrointestinal bleeding. In rare cases, celebrated
high blood pressure, acute renal develops
insufficiency, breathing is suppressed down to coma and develop
прочие анафилактоидные reaction. When started on time
symptomatic therapy all phenomena are reversible.

Drug interactions

An individual risk assessment of the use of Nimesil therapy is required.
while taking angikoagulyantov (warfarin), antiplatelet agents
(Clopidogrel), glucocorticosteroids (prednisone), selective
serotonin reuptake inhibitors SSRIs (Citalopram,
Sertraline).

Drug group Possible reactions when used together with Nimesil
Glucocorticosteroids Increased risk of gastrointestinal bleeding and development
ulcers
Antiplatelet agents, SSRIs Increased risk of gastrointestinal bleeding
Anticoagulants Increased risk of bleeding
Diuretics Weakening action
Antihypertensive drugs Weakening action, ухудшение функции почек
Lithium preparations Reduced clearance of lithium
CYP2C9 isoenzyme substrates Decreased blood concentration
Cytostatics Increased toxic effects
Cyclosporins Increased nephrotoxicity

special instructions

According to the instructions of Nimesil if the patient is at risk
возникновения ulcers, желудочно-кишечных кровотечений, а также при
simultaneous treatment with the above drugs, therapy
Nimesilom start with the lowest dose, watching the state
the patient. With the slightest adverse or undesirable reactions, treatment
stop.

  • Nimesil contains sucrose, which should be considered
    patients with diabetes mellitus: in 1 sachet 0.15-0.18 XE.
  • With the occurrence of ARVI and colds during therapy
    Нимесилом лечение stop.
  • Care should be taken during the treatment with Nimesil when
    driving a car and precise, dangerous jobs.

Shelf life

In hermetically sealed bags – 2 years. In case of violation
the integrity of the packaging drug can not be used.

Analogs

Analogsчными по составу, с действующим веществом nimesulide
The following medications are: Nemuleks, Aktasulid,
Aponil, Ameolin, Aulin, Nimesulid, Nimulid, Sulaydin, etc.
Some of them have several times lower cost at the same
efficiency with Nimesil. Difference granules for cooking
suspensions from tablets (cheaper) only in the fact that the effect
it comes a little faster due to faster absorption
suspension, and the efficiency remains the same.

ytvektrc ybvekbl ybvbrf
  • Nimesulide

100 mg. 20 pieces 70 rub.

Nimesulide Тева 100 mg. 20 pieces 170 rub.

  • Nise

100 mg. 20 pieces 200 rub.

  • Nemulex

гранулы для суспензии 100 mg. 30 pieces 500 rub.

  • Nimulid

tab. для рассасывания 100 mg. 20 pieces 200-250 rub., Suspension 60
ml. 200-300 rubles

  • Aponil

100 mg. 20 pieces 170 rub.

  • Nimika

100 mg. 20 pieces 230 rub.

Автор: врач-гигиенист, эпидемиолог

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